Reflection: 25/1/2021

Reflection: 25/1/2021                      hours: 2

What happened:

Today I had a remote consultation with a patient who I have been seeing for a few months with a suspected rotator cuff tendinopathy. He has been poorly with flu since the start of January and consequently has not been training for 3 weeks and has rested his shoulder. Last week he went back to training for the first time since Christmas and has so far suffered no pain but is still aware the injury is there. According to the continuum rest can be beneficial in allowing reactive tendons time to heal and return to a normal state (Cook et al., 2016; Cook & Purdam, 2009). The aim of the next few weeks is to gradually progress his training slowly, to ensure his body has time to adapt and damage does not occur again.

This patient has created his own training programme which he has been following, so it was important for us to assess whether it included sufficient rest time and progressive overload, whilst also being safe to minimise injury risk. It made me realise the importance of checking with patients how they train and who designed their programme to ensure that they are following safe and effective guidance to avoid over training and injury. This patient in particular watched a lot of YouTube videos to learn the correct form and how to design a programme, which may be dangerous if the information he received was not from a trusted or reliable source and therefore could pick up poor habits which could increase his risk of injury.

What I was thinking and feeling and what was good or bad:

I felt hopeful that this patient was starting to make progress and the isometric exercises I had been giving him to aid the recovery from his reactive tendinopathy was effective (Cook et al., 2016; Cook & Purdam, 2009).

What else I could have done/areas for improvement:

Look more into the use of other treatment modalities in the reactive stage to be used instead of or alongside isometrics.

Action plan:

  • Look into contrasting research surrounding the treatment of tendinopathy, to allow critical thought about Cooks model.


Cook, J. ., & Purdam, C. . (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409–416.

Cook, J. ., Rio, E., Purdam, C. ., & Docking, S. . (2016). Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? British Journal of Sports Medicine, 50(19), 1187–1191.

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